STATE OF CALIFORNIA
SINGLE DWELLING UNIT HOT WATER SYSTEM DISTRIBUTION - STORAGE
CEC-CF2R-PLB-02-E (Revised 06/14)
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION
Single Dwelling Unit Hot Water System Distribution
CF2R PLB 02 E
(Page 1 of 2)
Project Name:
Enforcement Agency:
Permit Number:
Dwelling Address:
City
Zip Code
VENTURA
A. General Information
01
Dwelling Unit Name
SINGLE FAMILY DWELLING
B. Design Dwelling Unit Water Heating Systems Information
This table reports the water heating system features that were specified on the registered CF1R compliance document for this project.
01
02
03
04
05
06
07
08
09
10
11
12
Water Heating
System ID or
Name
Water
Heating
System Type
Water
Heater
Type
DOMESTIC STORAGE
# of
Water
Heaters
in
system
Water
Heater
Storage
Volume
(gal)
ONE
Rated
Input
Type
Fuel
Type
GAS
Rated
Input
Value
BTU/HR ≤75,000
Heating
Efficiency
Type
EF
Heating
Efficiency
Value
≥ .58
13
14
Standby
Loss (%)
Exterior
Insul.
R Value
Central DHW System
Distribution Type
Dwelling Unit DHW System
Distribution Type
N/A
N/A
N/A
PARALLEL
C. Installed Dwelling Unit Water Heating Systems Information
01
Water Heating
System ID or
Name
02
Water
Heating
System Type
03
04
05
06
07
08
09
10
11
12
13
14
Water
Heater
Type
# of
Water
Heaters
in
system
Water
Heater
Storage
Volume
(gal)
Fuel
Type
Rated
Input
Type
Rated
Input
Value
Heating
Efficiency
Type
Heating
Efficiency
Value
Standby
Loss (%)
Exterior
Insul.
R Value
Central DHW System
Distribution Type
Dwelling Unit DHW System
Distribution Type
DOMESTIC STORAGE
ONE
GAS
BTU/HR
EF
N/A
N/A
N/A
PARALLEL
D. Installed Water Heater Manufacturer Information
01
02
03
Water Heating
System ID or Name
Manufacturer
Model Number
CA Building Energy Efficiency Standards 2013 Residential Compliance
June 2014
STATE OF CALIFORNIA
SINGLE DWELLING UNIT HOT WATER SYSTEM DISTRIBUTION
CEC-CF2R-PLB-02-E (Revised 06/14)
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION
Single Dwelling Unit Hot Water System Distribution
CF2R PLB 02 E
(Page 2 of 2)
Project Name:
Enforcement Agency:
Permit Number:
Dwelling Address:
City
Zip Code
VENTURA
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1.
I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Documentation Author Company Name:
Date Signed:
Address:
CEA/HERS Certification Identification (If applicable):
City/State/Zip:
Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1.
2.
The information provided on this Certificate of Installation is true and correct.
3.
The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and
regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency.
I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this
Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met.
I will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the
enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides
to the building owner at occupancy.
4.
5.
I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features,
materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible
builder/installer), otherwise I am an authorized representative of the responsible builder/installer.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
Address:
CSLB License:
City/State/Zip:
Phone
CA Building Energy Efficiency Standards 2013 Residential Compliance
Date Signed:
June 2014